Individual
BOMI KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1234 WILSHIRE BLVD APT 335, LOS ANGELES, CA 90017-1979
(213) 222-7255
Mailing address
1234 WILSHIRE BLVD APT 335, LOS ANGELES, CA 90017-1979
(213) 222-7255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA57376
CA
Other
Enumeration date
05/08/2019
Last updated
04/21/2025
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